FORM 1023-EZ for DAZYS WAY

Field Data
EIN 82-0641570
Case Number EO-2017156-000100
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DAZYS WAY
Organization’s Mailing Address 5412 RAINBOW DRIVE
City EAST PETERSBURG
State PA
ZIP 17520
Accounting period End 12
Primary contact name GRAHAM SMALL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KELLIE CICERO
EXECUTIVE DIRECTOR
5412 RAINBOW DRIVE
EAST PETERSBURG PA 17520

Officer/Director/Trustee Two

GRAHAM SMALL
DIRECTOR OF FINANCE
434 HOLLY STREET
ELIZABETHTOWN PA 17022

Officer/Director/Trustee Three

SUSAN RICHIE
SPECIAL EVENTS COORDINATOR
46 BRITTANY LANE
GLENMOORE PA 19343

Officer/Director/Trustee Four

JENNIFER HUMMER
SOCIAL MEDIA COORDINATOR
36 MAIN STREET
MARIETTA PA 17547

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/22/2017
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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